Becker's Hospital Review

27 CFO / FINANCE UMass Memorial Points to Epic Implementation for Drop in Operating Income By Ayla Ellison W orchester, Mass.-based UMass Memorial Health Care saw revenue increase in fiscal year 2016, but the system said costs associated with implement- ing an Epic EHR system dragged down operating income. UMass Memorial recorded revenue of $2.4 billion in FY 2016, up 5.8 percent from the year prior. The financial boost was largely attributable to a 6 percent year-over-year increase in patient service revenue, which grew to $2.3 bil- lion in FY 2016, according to recently released bondhold- er documents. The system ended the most recent fiscal year with operat- ing income of $40.7 million, down from $72.2 million in FY 2015. The decline was largely attributable to $25 million in training and implementation costs associated with its new Epic EHR platform. UMass Memorial officials announced plans to adopt Epic's EHR system in 2015. The project is expected to cost $700 million over a 10-year period. UMass Memorial CFO Sergio Melgar told the Boston Busi- ness Journal the system expects Epic training costs to be about $50 million in FY 2017, but "most of the impact will be in fiscal 2018 in the beginning [of the year]." UMass Me- morial plans to go live on the new system in October 2017, according to the report. n 20 Health Conditions People Spent Most on in 2013 — and What the Bulk of Their Money Went Toward By Molly Gamble O f 155 medical conditions, people personally spent $1.2 trillion on the top 20 alone in 2013, according to a new analysis published in JAMA. In their investigation "US Spending on Per- sonal Health Care and Public Health 1996- 2013," study authors collected and combined 183 sources of data to estimate spending for 155 conditions. ey found the top 20 condi- tions accounted for an estimated 57.6 percent of personal healthcare spending in 2013. Below is a ranking of the 20 top conditions, with spending amounts reflecting 2015 dol- lars. Each entry also contains where the ma- jority of those dollars went — authors broke down the portion spent on ambulatory care, inpatient care, pharmaceuticals, emergency care or nursing facility care. Because cancer was disaggregated into 29 separate condi- tions, none were among the top 20 with the highest spending. 1. Diabetes — $101.4 billion; majority of spending on pharmaceuticals (57.6 percent) 2. Ischemic heart disease — $88.1 billion; majority of spending on inpatient care (56.5 percent) 3. Lower back and neck pain — $87.6 billion; majority of spending on ambulatory care (60.5 percent) 4. Hypertension treatment — $83.9 billion; majority of spending on ambulatory care (45.8 percent) 5. Falls — $76.3 billion; majority of spending on inpatient care (34.3 percent) 6. Depressive disorders — $71.1 billion; ma- jority of spending on ambulatory care (53.1 percent) 7. Oral disorders (oral surgeries and pro- cedures including crowns, extractions and dentures) — $66.4 billion (minor portion of spending goes to prescriptions or ambulatory, inpatient, emergency or nursing facility set- tings) 8. Sense organ diseases (cataracts, vision correction, adult hearing loss and macu- lar degeneration) — $59 billion; majority of spending on ambulatory care (85.4 percent) 9. Skin and subcutaneous diseases (cellu- litis, sebaceous cysts, acne and eczema) — $55.7 billion; majority of spending on am- bulatory care (52 percent) 10. Pregnancy and postpartum care (nor- mal pregnancy, including cesarean deliv- ery) — $55.6 billion; majority of spending on inpatient care (50.5 percent) 11. Urinary diseases and male infertility (urinary tract infections and kidney cysts) — $54.9 billion; majority of spending on am- bulatory care (37 percent) 12. Chronic obstructive pulmonary disease — $53.8 billion; majority of spending on in- patient care (34.8 percent) 13. Hyperlipidemia treatment — $51.8 bil- lion; majority of spending on pharmaceuti- cals (78.5 percent) 14. Dental well care (general exams, clean- ings, orthodontia and X-rays) — $48.7 bil- lion; majority of spending N/A 15. Osteoarthritis — $47.9 billion; majority of spending on inpatient care (63.8 percent) 16. Other musculoskeletal disorders (joint, muscular and connective tissue disorders) — $44.9 billion; majority of spending on am- bulatory care (49.4 percent) 17. Cerebrovascular disease — $43.8 billion; majority of spending on inpatient care (54 percent) 18. Other neurological disorders (pain syn- dromes and muscular dystrophy) — $43.7 billion; majority of spending on ambulatory care (50.9 percent) 19. Other digestive diseases (esophagus conditions and diverticulitis of the colon) — $38.8 billion; majority of spending on am- bulatory care (39 percent) 20. Lower respiratory tract infections — $37.1 billion; majority of spending on in- patient care (48.6 percent) n

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